Provider Demographics
NPI:1609437185
Name:GUIMARAES, MARIANA ANDRADE (AP)
Entity type:Individual
Prefix:MRS
First Name:MARIANA
Middle Name:ANDRADE
Last Name:GUIMARAES
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12525 ORANGE DRIVE SUITE 713
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330
Mailing Address - Country:US
Mailing Address - Phone:818-424-0958
Mailing Address - Fax:
Practice Address - Street 1:12525 ORANGE DRIVE SUITE 713
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330
Practice Address - Country:US
Practice Address - Phone:818-424-0958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4033171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist